Article Text
Abstract
Background In Zambia, from March 2019, strict adherence to public health guidelines during implementation of essential or COVID-19 related research studies inadvertently impacted the conduct of community engagement (CE). We share our experience of establishing and navigating CE in a TB research study pivoted to include COVID-19 in Zambia.
Methods Different approaches were adapted to solicit CE for different study phases. Phone-based individual conversations (n=6) with community representatives and district health officials, and phone-based group discussions (n=4) with community members were held to obtain initial COVID-19 community experiences and informed protocol development. In addition, low-risk face-to-face meetings (n=8) were held with community members, following COVID-19 guidelines, to deepen understanding of the community experiences. Prior to study commencement, meetings (n=4) with community representatives were held, leading to formation of a COVID-19 Community Team (CCT) to guide study implementation. Meetings with the CCT (n=5), health facility staff (n=3), and sensitization activities (n=20) were held during implementation, and these CE activities were evaluated using observations (n=8), individual interviews (n=8) and focus group discussion (FGD: n=5).
Results Community engagement helped researchers to identify information and knowledge gaps and dynamics, local experience, and supported interaction between community and the health facility. Further, establishing the CCT generated community agency for COVID-19. However, phone-based conversations and discussions, though useful, were limited in quality by poor network, limited number of participants on a single call, and limited ownership of a working phone. Face-to-face CE activities were also undermined by strict adherence to COVID-19 public health and institutional guidelines that prevented social etiquette (e.g. handshakes) and more extended community interactions.
Conclusion Although establishing and navigating CE during the COVID-19 pandemic was feasible, the reach and quality of community engagement was compromised by COVID-19 restrictions. Therefore, a combination of the remote and face-to-face research approaches is required going forward.